| NPI | 1275420457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE VAUGHT Owner 645-216-8892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-06-20 |
| Last Update Date | 2025-06-20 |